DIRIGO’S EARLY RESULTS

DirigoHealth is Maine’s long-term response to the chronic problem here (and in all other states) of high health insurance costs and health care priced out of reach of too many residents. A new survey suggests that for thousands of Mainers, Dirigo is working well, but more important than passing judgment on this complex program now is to urge lawmakers to give it time to fully prove itself.

The survey, by Taryn Bowe at the University of Southern Maine’s Muskie School of Public Service, found that interest in DirigoHealth insurance continues to be strong, with more than 8,100 Mainers getting coverage. Most of those people had some form of coverage before switching to Dirigo, but 40 percent of those had to pay at least $2,500 out of their own pockets each year before their insurance started covering them. That cost kept many from going to a doctor or a hospital for care until they were seriously ill, which meant their care was more expensive.

Many others, according to the survey, had coverage with gaps in their policies – no coverage for routine check-ups, mental health or prescriptions, for instance.

Perhaps worse than having no coverage at all, inadequate insurance still costs buyers a lot without providing the kind of service most people take for granted. Like a paper umbrella, it is useful until needed.

Not surprisingly, the survey points out Dirigo has a waiting list of about 3,000 individuals and sole proprietors. Sign up begins again in January, but as the public gains confidence that the program is going to be around, even more people will want to sign up. The administration should be prepared to keep those lists as short as possible to provide coverage and build further confidence in the system.

But Dirigo will deliver only if it also improves the quality of care while expanding coverage and reducing costs. That will take time – time to gather data to measure quality and more time to agree on steps to improve it. For instance, one goal of Dirigo is to create, with the proper privacy standards, an electronic health record for each Maine resident. That record would be available to any health provider when the resident needed care. It would speed treatment and improve outcomes, but it won’t arrive overnight. Dirigo also needs time to show hospitals that it can consistently reduce the amount of bad debt and charity care they provide.

The recent survey’s most important outcome was that positive interest exists in seeing Dirigo succeed, even as it will necessarily be modified as experience and demand require. Lawmakers last winter sometimes fretted that this expansion of the state’s role into health care would be a costly mistake. At this early stage in Dirigo’s life, the evidence suggests otherwise.